Roughly one in seven people in England was prescribed an antidepressant item in 2025–26 — the highest level ever recorded in the NHS Business Services Authority’s statistical collection. The response was predictable: alarm, and a search for someone to blame. Dean Burnett, a doctor of neuroscience, thinks the blame has landed in the wrong place, and that the numbers describe something simpler and less flattering than a profession handing out pills.
The claim he is arguing against is “overprescribing” — that patients get antidepressants when they shouldn’t, or when better and safer alternatives exist. He quotes Dr John Read, a professor of clinical psychology, making that case in the Daily Mail, on the grounds that doctors are “increasingly being expected to treat wider social and life problems with medication.”
What the rise actually tracks
Antidepressant use has risen alongside diagnoses of depression and anxiety, and the pandemic is a large part of that story. ONS data show the rate of depressive symptoms in British adults doubled during the Covid crisis to almost one in five, and as of April 2025 the figures remain almost as high. NHS survey data put one in four young people in England as having a mental-health condition. Against that background, Burnett argues, rising prescribing is the expected outcome rather than an anomaly requiring an explanation.
Then there is the geography, which is where his argument gets its teeth. The steepest increases in antidepressant use are in the most impoverished regions of England, while affluent regions report modest levels. The highest rate sits with the North East and North Cumbria integrated care board at 200 prescriptions per 1,000 patients — an ICB whose own communications describe areas that have “faced longstanding inequalities and poor health for decades.” Poverty and poor mental health are not two problems that happen to overlap; chronic stress is one of the main mechanisms joining them, and a life of constant poverty guarantees a supply of it.
That is why Burnett treats the “social problems versus medical problems” distinction as the weak joint in the overprescribing case. If the social condition is producing the depression, then treating the depression is not a category error — it is the only thing the health service can actually do at the counter.
Why the pill comes first
The argument for talking therapies as first-line treatment runs into arithmetic. CBT means regular one-to-one sessions with trained counsellors, and NHS waits for those regularly run months, if not years — worse in the poorest areas, where need is highest. Antidepressants are available straight away. A GP who offers a prescription to someone who cannot get seen by a therapist for six months is not ignoring the guidelines; they are working inside them. NICE states that practitioners should “not routinely offer antidepressant medication as first-line treatment for less severe depression unless that is the person’s preference.”
Burnett is not arguing that record use is fine. He calls it a problem that should prompt reflection, points to services that need deep reform and more funding, and notes the government’s May 2026 strategy aimed at shifting spending from crisis intervention to prevention, plus NICE-recommended digital therapies for depression and anxiety — tools meant to free up therapist hours without simply medicating more people.
His conclusion is narrow: the rate is a problem, but attributing it to overprescription mistakes a symptom for its cause. The causal story he points at runs through deprivation, chronic stress and waiting lists — which is also, awkwardly, the part of the story that no prescribing guideline can address.